Increasing the capacity of our technology appraisals - the proportionate way

Jenniffer Prescott describes how we are trialling a proportionate approach to technology appraisals, which we expect will increase our capacity by 20% from 2023/24.

By Jenniffer Prescott, programme director of HTA process and operations at NICE

I’ve seen many changes to the health and care landscape since I’ve been at NICE – some more significant than others. But I feel that the point we’re at now is particularly striking.

New, innovative, and potentially disruptive treatments are being developed at a pace we haven’t seen before – leading to medicines of great range and complexity. As a health technology agency, it’s our duty to ensure we’re delivering rapid, useful and usable advice on such treatments. And especially on those treatments that promise the greatest benefit to people and patients.

But not all new treatments easily fit into our existing technology appraisal processes. There are a few which take up a large proportion of our time. This could risk other potentially simpler appraisals being delayed due to a lack of capacity.

So we need to adopt a more efficient approach to our technology appraisals - where we can learn from previous decisions and approaches - and use this learning for future efficiency gains.

To achieve this, we're embarking on a new, proportionate approach to our appraisal processes. We expect this approach will increase our capacity by 20% from 2023/24 - ensuring we’re using resources most appropriately, and that people and patients can continue to access promising treatments. 

What is the proportionate approach to technology appraisals?

The proportionate approach will help differentiate our appraisal processes. It will provide a clear route for different types of treatments. This will allow us to apply light-touch, faster evaluations to simpler low-risk treatments, such as licence extensions of medicines, or in disease areas we are already familiar with. As a result, we’ll be able to dedicate more time to consider complex treatments that need bespoke, detailed attention. 

First steps: Pilots and a new ‘safe space’ for co-creation

We’ll achieve this by initially running pilots for potential lighter-touch evaluation approaches to treatments that should take up significantly less time and resources. We’ll use the learning from the pilots to inform what a light-touch approach might be for appropriate treatments.

To help with the development of new methods and processes, we’re also a developing a new Health Technology Assessment innovation Laboratory (HTA Lab). The HTA Lab will offer a 'safe space' enabling us to design, test and co-create new HTA methods and processes with our stakeholder community - taking innovation from the lab and into practice. The HTA Lab will inform our proportionate approach as well as feed into other methods and processes that occur at NICE. You can read more about the HTA Lab in Nick’s blog.

How will this approach benefit patients and people?

We expect that a proportionate approach will increase our capacity for new evaluations by 20% by 2023-24. This will enable NICE to scale up its technology appraisal outputs to cover all new drugs that receive a licence. It will also ensure both we, and our partners that are involved in the process, are making the best use of our resources. 

By working in parallel with the regulatory processes, the NICE process for technology appraisals is among the fastest in the world for health technology evaluation. As we expect to produce even more recommendations, it is important that a proportionate approach will ensure that the NICE process continues to provide the opportunity for promising treatments to reach people and patients quickly. 

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